Abstract：
:Recent reports of total knee prosthesis fractures have raised concerns over the long-term structural integrity of metal-backed tibial components. Both the development of a fibrous tissue membrane under the tibial plateau of a total knee prosthesis and loading conditions may seriously alter the fatigue life of the metal tibial tray. The effects of the cement and fibrous tissue at the bone-prosthesis interface were studied. Using the method of three-dimensional finite element analysis, peak loads of normal gait were simulated at several locations on the plateau of a generic, single-stemmed, porous-coated, CoCrMo tibial component model, providing information on the effect of abnormal loading patterns. According to the analysis, stresses below the material endurance limit are predicted throughout the prosthesis prior to the development of the fibrous membrane. However, stresses exceeding the yield strength of the material are predicted in a prosthesis that is supported by a fully developed 1 mm membrane, meaning that it has a markedly increased risk of low-cycle fatigue failure. Lateral displacement of the loading is detrimental to prosthesis life because maximum stress increases 100% while posterior displacement of the loading increases maximum stress by only 30%. Anterior loading creates stresses similar to those created by central loading. Because of their susceptibility to low-cycle fatigue failure, simple, single-stemmed prostheses are not recommended in cases of questionable bone stock unless modified. Several design alternatives are proposed.
journal_name
Orthopedicsjournal_title
Orthopedicsauthors
Paganelli JV,Skinner HB,Mote CD Jrsubject
Has Abstractpub_date
1988-08-01 00:00:00pages
1161-8issue
8eissn
0147-7447issn
1938-2367journal_volume
11pub_type
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